Apparatus for administration of anaesthetics



Dec. 30, 1958 o. w. DE LA TORRE APPARATUS FOR ADMINISTRATION OFANAESTHETICS Filed March 23. 1953 7 Sheets-Sheet l @W. MATT AIAIII Y.LWW Ag,

' 1953 o. w. DE LA TORRE "2,866,455

APPARATUS FOR ADMINISTRATION OF ANAESTHETICS Filed March 23. 1953 '7Sheets-Sheet 2 MMAJw AW BY A. 0AM

Dec. 30, 1958 o. w. DE LA TORRE 2,866,455

APPARATUS FOR ADMINISTRATION OF ANAESTHETICS Filed March 25, 1955 '1Sheets-Sheet 5 J54 J55 J05 Dec. 30, 1958 o. w. DE LA TORRE APPARATUS FORADMINISTRATION OF ANAESTHETICS Filed March 23. 1953 7 Sheets-Sheet 41958 o. w. DE LA TORRE 2,866,455

APPARATUS FOR ADMINISTRATION OF ANAESTHETICS Filed March 23. 1953 I 7Sheets-Sheet 5 172 A 165 JH J64 1 I f i J70 I 1 I I/ 10 o l I #4 3 5 7 lJ'58 i 8 JJ ll INVENTO J20 m 421062, m 1165/ 119 BY A. fl @1 4 1958 o.w. DE LA TORRE 2,866,455

APPARATUS FOR ADMINISTRATION OF ANAESTHETICS Filed March 23. 1953 '7Sheets-Sheet 6 J44 A5? J46 jag 147 198 1629 .209"

1958 o. w. DE LA TORRE 2,866,455

APPARATUS FOR ADMINISTRATION OF ANAESTHETICS Filed March 23. 1953 7s-Sheet 7 BY j20 mm? g e S at s P ten 2,866,455 .1 Patented Dec. 30,1958 APPARATUS FOR ADMINISTRATION OF ANAESIHETICS Oscar W. de la Torre,Buenos Aires, Argentina Application March 23, 1953, Serial No. 343,927

13 Claims. (Cl. 128-188) This invention relates to an apparatus for theadminis-. tration of anaesthetics and more particularly the presentinvention relates to an apparatus for administrating anaesthetics duringchildbirth.

Although reference will be mainly made, when describ ing this invention,to an apparatus for the administration of anaesthetics in childbirthwhich apparatus permits reduction practically to insensibility'the painsof labor and at the same time to practice a reanimation or revival onthe child just born, it is to be understood, that, as will be apparentto those skilled in the art, that it is possible to apply this apparatusfor administration of anaesthetics in general, that is to say foroperations of any kind.

The apparatus has been so designed as to enable the use of modernanaesthetics and more particularly the use of trichloro ethylene(CHCl:CCl which is known to be a most excellent anaesthetic but has thedisadvantages of having a high density (4.53; air=1) so that in order toobtain sufiicient evaporation, upon passing a current of air or oxygenalong its surface it requires the design of special means. Furthermoreit has to be kept in mind, that the application of trichloro ethylenehas a determined limit, so that under certain circumstances areinforcing volatile anaesthetic agent such as ether, chloroform orethyl chloride is usually required and the apparatus of the presentinvention, provides means which permit said reinforcing anaesthetic tobe added. I

The apparatus is further provided with a control system for controllingthe flow of oxygen so that the concentration of the anaesthetic vaporscan be changed in accordance with the requirements, without having tomodify the apparatus per se.

When the apparatus is used for administration of anaesthetics inchildbirth, a reanimating system is added for the child just born, whichis based on the principle'of oxygenation, to which end suitablemeans aresupplied which enable at the same time the anaesthetic and analgesictreatment of the delivering mother.

7 The devices which have been conceived up to now and in which it ispossible to use a heavy anaesthetic, do no provide the necessary meansfor adequately evaporating said anaesthetic. I

A further drawback of the known devices resides in that the latteraccumulate carbon anhydride, so that during the anaesthetic treatmentthe mask must be intermittently withdrawn to eliminate said carbonanhydride; the result thereof is that the percentage of the anaestheticsupplied varies continuously and often produces undesirable excitementof the patient.

In substantially all the known devices for producing anaesthesia, aswell as in any other device wherein a constant flow of gas is required,and particularly in those cases wherein the required pressure isrelatively low with regard to the source of pressure, it is commonpractice to use a secondary supply source, which may consist of a smalltank or bottle in which the gas is stored at approximately the requiredpressure, which secondary source is successively recharged by the mainsource;

? and This is necessary in order to insure that the commonly usedtextile sheathed rubber tube does not explode or slip off the nipples,which happens when the rubber tubes are directly coupled to the mainsource of high pressure with the obvious consequences. 0n the otherhand, the con-' tinuous refilling or recharging of the secondary source,is a definite drawback, especially in apparatus for administratinganaesthetics, which often have to operate continuously for rather longperiods.

In order to eliminate 'said secondary supply source, a constant flowpressure means has been conceived which enables the latter to beconnected for example to' an oxygen tube of the high pressure type anddeliver under all circumstances the required low pressure. to theap:paratus to be fed. 7

A number of further drawbacks could bemore specifically described suchas the failure of known apparatus to provide means for cutting out theanaesthetics and supplying pure oxygen, but it is considered that theforegoing gives a sufficient picture of the art.

Bearing in mind the above there has been provided apparatus foradministration of anaesthetics. This comprises an intake connection foroxygen and the like, a flow control valve means connected tosaid intakeconnection, a first container for housing and evaporating a firstanaesthetic, and a flow directing device havingan admission end and anexit. The admission end of said flow directing device is connected tosaid flow control valve means, and said first container is connected tosaid flow. directing device. There is further provided a control meansin said flow directing device for directly connecting said admission endto said exit and closing ofl said first container, a one way valveconnected to said exit permitting flow from said admission end throughsaid exit, as well as a collapsible container connected to said one wayvalve. Also there is provided a second container for housing a secondanaesthetic and having a flow control, said second container beingconnected to said collapsible container, said collapsible containerbeing also directly and controllably connected to said flow controlvalve means and an administrating mask connected to said collapsiblecontainer.

It is an object of the invention to provide an apparatus for theadministration of anaesthetics of relatively small size and low weightso as to make it a portable apparatus.

A further object is to provide an apparatus which permits a supply ofmixture of several anaesthetics and oxygen or oxygen alone and which hasadditional valves which enable to connect the apparatus directly to theair at several points in case the oxygen supply source is empty, or forother purposes as will be later specified.

Another object is to supply an apparatus which is provided with aconstant flow pressure means to be located between the oxygen supplysource and the intake connection so that the apparatus may be directlyconnected to ahigh pressure supply source in spite of which theadministration of the anaesthetics or oxygen is constant and withoutsubstantially any variations as far as pressure is concerned.

A still further object of the invention is 'to. provide an apparatuswhich due to the arrangement of suitable valves eliminates the carbonanhydride which cannot reach the anaesthetics evaporating system.

Another object is to provide an apparatus which when used in childbirthis provided with additional means for reanimating the newly born child.

A further object is to provide an apparatus by means of which theanaesthetic gases can be eliminated from the system at will without thenecessity ofwithdrawing the mask from the patient.

Another object is to provide an apparatus of simple. structure and whichmay be easily cleaned.

' These and further objects and advantages will become more apparentduring the course of the following description, in which by way ofexample a specific embodiment as well as a modified embodiment have beenshown.

In the drawings:

Figure 1 is a front elevation of the constant flow pressure meansprovided with a branch for reanimation in case said constant flowpressure means is used in childbirth or in other cases wherein a secondbranch for oxygen supply, such as oxygen tents, is required.

Figure 2 is a side elevation of the constant flow pressure means, shownin Figure 1.

Figure 3 is a partial longitudinal sectional view of the constant flowpressure means shown in Figure 1.

, Figure. 4 is a partial longitudinal sectional means of the constant.flow pressure means shown in Figure 2.

Figure 5' is a detail in side elevation of an element integrant of theconstant flow pressure means.

Figure 5 is a. detail in front view of a modification which may be usedin theconstant flow pressure means shown in Figure 1.

Figure 7 is a partial sectional side. elevation of the detail shown inFigure 6. Figure 8 is a perspective front view, with a part broken away,of the main part of the apparatus for administration of anaesthetics, inaccordance with the present invention.

Figure9. is a bottom plan view of the main support with. accessories ofthe apparatus for administration of anaesthetics, in accordance with thepresent invention.

Figure is a side elevation of the part of the apparatus shown in Figure8.

Figure 11 is a detail in longitudinal section of the flow directingdevice to which the collapsible. container and the evaporating aid ofthe first container is connected.

Figure 12 is a longitudinal section. of the flow control valve means.

Figure 13 is a plan view of the flow control valve means shown in Figure12.

Figure 14 is a longitudinal section of the control valve for connectingthe how control valve means to the collapsible container.

Figure is a plan view of the control valve mounted on the main supportand part of its connecting tubes.

Figure 16 is a perspective view of the evaporating. aid of the firstcontainer.

. Figure 17 is a side elevation, partially in section, of the holder ofthe main support.

Figure 18 is a top plan view of the holder shown in Figure 17.

Figure. 19 is a side elevation,,partially in. section, of the main mask.

Figure;20. is a longitudinal section of the control valve of. themainmask.

Figure,- 21, is a perspective view ofan element shown in. FigureZO.

Figure.22-. is a side elevation. partially in section, of the babys.mask" with part of its collapsible container.

Figure. 23; is an end view of part of the mask shown in Figurey22c Asmaybe best seen in Figures 1 and 2, theconstaut flow pressure means 1consists of a main casing Z'integral with. an admission arm 3 havingcoupling means for connectingcit to. the supply source and furthercomprising a manometer 4 for measuringthe pressure of the supply source,usually an oxygen bottle, a constant flow'pressure valve 5, and acontrol valve, or control means 6 for varying the position of theconstant flow pressure valve, a main, nipple 7 for forwarding the gasunder constant pressure, a secondary ipple 8 mounted: on. a needleby-pass valve 9 and a safety valve.10.; The.admission arm3 (see Figure.3) comprises, adjacent to :its

front end'portion 3.; said coupling. means. which consists:

o! a shoulder 11 and an internally threaded nut 12 abutting against theshoulder 11. The free end portion 3' is provided with an internallythreaded boring 13 in which a filter element 14 is housed and protectedfrom outside by a perforated closure member 15 which is screwed intoboring 13 and pressing the filter element 14 against a supply boring 17which connects the outside through the perforation 15 of the closuremember 15, filter 14, with the main casing 2. A vertical boring 16(Figure 4) in the main housing 2 connects boring 17 with the manometer4, whereby said manometer indicates the pressure of the supply source.The valve 6 serves as a control valve since it controls. the pressure ona diaphragm. or rubber plate 32.

The internally threaded nut 12.is directly mounted on the dischargeopening (not shown) of the oxygen tube or the like and in order toinsure a hermetical sealing, a washer 18 is housed in said nut 12abutting against the shoulder 11'. The. main casing 2 comprises a frontchamber 19 (Figure 4)' and a smaller back chamber 20, separated by themain partition wall 2 of said casing 2. The front chamber 19 and backchamber 20 are interconnected by three cross borings 21, 22 and 22 insaid main partition wall 2'. The back chamber 20 is also connected tothe supply boring 17 by means of prolongation 17. Thus, front and backchambers 19 and 20, re spectively, are connected to the supply boring17.

The main nipple 7 is connected to the front chamber 19 by means ofconduit 23 and thereby the main nipple 7 is also connected to the supplysource (not shown). It is however an object of the constant flowpressure means 1, to supply the gas under a predetermined con stantpressure to the main nipple 7 and to this end the constant flow pressurevalve 5 and control valve 6 are necessary which operate in combination.

The constant flow pressure valve consists of a cylindrical housing 24which is screwed into a ring-like projection 25, integral with the maincasing 2. A constant flow valve member 26 is slideably housed in saidcylindrical housing 24 and comprises a valve head 27 that is capable ofblocking the opening of prolongation 17' and a valve spring 28, one endof which abuts against the base of the cylindrical housing 24, while theother end is housed in a recess 26 of said constant flow valve member26.

The control valve 6 includes a control member 29, consisting of a disk30 (see Figure 5) and two separated distance pins 31, which areslideably housed in said cross borings 22 and 22'. A rubber plate 32 ofcircular shape seals the front chamber 19 from the outside and whichrubber plate 32 is in contact with saidcontrol member 29 and ismaintained in its sealing position by means of cover. 33 screwed intothev main casing 2. Said cover comprises a cylindrical hollow.projection 34 having a plurality of radial. perforations 35, which arearranged adjacent to said; cover 33. A, disk-like, member 36 of smallerdiameter. than the disk 30'of the control member 29 is.located.in frontof said disk 30 and enters in contact therewith through said rubberplate 32. Conveniently the diameter of said disk-like member 36 issmaller than the diameter of the hollow of said cylindrical projection34 so, that it may enter thereinto. The free end portion 34 of saidcylindrical hollow projection 34 is provided with a threaded perforation37 in which an adjusting screw 38 is housed having an actuating endportion 33' commanding a false support 39 of a helical pressure spring.40, the other end of which operates on said dislilike. member 36. Acover screw 41 closes the access to said adjusting screw 38.

It will thusbe understood that by varying the position of the adjustingscrew 38, such as by displacing it towards the main casing 2, thepressure exerted by helica pressure spring 40 onto the control. member29 through the disk-likemember 36 and rubber plate 32. will be ingreased, whereby, thedistance pins 31 will displace the constant flowvalve member 26 in opposition to the presinto the back chamber will passthrough the cross boring 21 at a higher pressure to the front chamber 19wherefrom it passes through the conduit 23 into the main nipple 7. Incase the rubber plate 32 is injured, as for example, if the pressure inthe supply source increases due to any unforseeable event, the helicalpressure spring 40 will be compressed and the excess of gas will be ableto leave the main chamber through the radial perforations 35.

For safety purposes the constant fiow pressure means and moreparticularly the front chamber 19 is connected through boring 42 to thesafety valve 10 (Figure 3) which consists of a valve head 42 located ina projecting arm 43 and provided with the commonly known spring 44 andexit opening 45, as is well known in the art.

So far the valve has been described as a constant flow pressure means.It may however be necessary to provide a second connection by means ofwhich an additional supply of gas may be provided and to which end thefront chamber 19 is connected to a boring 46 in which the needle by-passvalve 9 is housed consisting of a handle 47 having a threaded stem 48ending into a needle 49 for controlling the amount of gas capable ofleaving through the secondary nipple 8. The usual type of stuffing box50 provides the gas tight joint for the stem 48.

As a modified embodiment, the same constant flow pressure means ashereinbefore described, may be provided with acontrol adjusting screw,such as shown in Figures 6 and 7, wherein the false support 39 iscontrolled by an adjusting screw 38a that is integral with a,

handle 51 and the handle has an indicator 52 in operative relationshipwith a scale 53. Upon turning said handle 51 the pressure on the helicalpressure spring 40 may be varied.

The apparatus for the administration of anaesthetics comprises a mainsupport 101 (see Figure 8) which is provided with a flow control valvemeans 102 that is connected to an intake connection 103. A firstcontainer 104 for housing and evaporating a first anaesthetic 104, sucha trichloro ethylene is supported by said main support 101. A flowdirecting device 105 is connected to said flow control valve means 102through an oxygen flow measuring means 106 and said flow directingdevice 105 is also connected to said first container 104 and is alsoprovided with a by-pass, as will be later explained, and this is for thepurpose of directly connecting said flow measure means to a collapsiblecontainer 107 which on its turn is also connected to a second container108 for housing a secondanaesthetic.

The intake connection 103, as may be better seen in Figure 9, consistsof a textile sheathed rubber tube, the other end of which is connectedto the main nipple 7 of the constant flow pressure means 1. The intakeconnection 103 is mounted on a nipple 109 (Figure 13) that is integralwith the casing 110 of the flow control valve means 102. Said casing 110(Figure 12) comprises a cylindrical threaded projection 111 whichpasses-through a bore 112 of the main support 101 and a nut 113 andcounternut 114 mounted on said cylindrical projection 111 fix the flowcontrol valve means 102 to said main support 101. A suitable gasket 115is located between said counternut 114 and said cylindrical projection111 for a partially threaded needle valve stem 116 operated by means ofa handle 117. Said needle valve stem 116 is screwed into the main bore118 of the casing 110 and controls the admission opening which connectsthe flow control valve means 102 to the nipple 109. A first branch 119and a 6 second branch 120 are connected tosaid main bore 118 By openingthe needle valve stem 116, an equal quantity of gas, and in theparticular case, oxygen, is capable of flowing both through the firstbranch 119 as well as through the second branch 120. As may be betterseen in Figure 9, the first branch 119 is connected to a tube 121relating said first branch 119 with the flow measure means 106consisting of a vertical transparent tube 122 (see Figure 8) mounted ina support 123 fixed to the main support 101 and on which support 123 ascale 124 is marked. A float 125 is slideably housed in said transparenttube 122. A convenient glass protection 126 may surround saidtransparent tube 122. The upper end of said transparent tube 122 isconnected to a return pipe 127 part of which is located underneath themain support 101, as may be seen in Figure 9, and is connected to thesupply pipe 128 (see Figure 8) of the flow directing device 105.

Since the largest diameter of the float 125 is slightly smaller than theinternal diameter of the transparent tube 122, upon opening the flowcontrol valve means 102 by handle 117, the float 125 will rise in saidtransparent tube 122 up to a certain level and the horizontal planepassing tangentially by the upper end of said float will indicate at thescale 124 the volume of oxygen which passes through the flow controlvalve means 102 at a determined unit of time; the more the valve means102 is opened, the higher the float 125 will rise in said transparenttube 122.

The flow directing device 105 comprises a basic support 129 having anupper rim 129' (see Figures 10 and 11) which engages the upper surfaceof the main support 101 and passes partially through an opening arrangedtherein so that the lower part of said basic support projects out of themain support as may be seen in Figure 9. Said basic support is providedwith an internally threaded section 129" and a washer 130. The firstcontainer 104 (see Figure 8) is screwed into said basic support 129 andmore particularly supported by said threaded section 129" and the washer130 provides a gas-tight seal. The top of the basic support 129 isintegral with a tubular member 131 having an admission end portion 131'to which the supply pipe 128 is connectedi Inside said admission endportion 131' a cylindrical air connecting member 132 is rotatablyhoused, which air connecting member is provided with an actuating knob133 emerging through a slot 134 (Figure 8) arranged in the admission endportion 131'. The cylindrical air connecting member 132 is also providedwith a slot 135 of similar size as said slot 134 so that upon rotatingsaid cylindrical air connecting member 132, upon registry of the slots134 and 135, the inside of the tubular member 131 will be connected withthe outside. In the position shown in Figures 8 and 11, this airconnection is closed and it is only opened in case the supply pipe 128is not able to supply the required oxygen.

Adjacent to the cylindrical air connecting member a flow directingcylinder 136 (Fig. 11) is rotatably housed der 136 is provided with anactuating knob emerging through a slot 146 (Figure 8) arranged in saidtubular member 131. The exit end portion 131" is covered by a cup 147having an exit 147' controlled by a one-Way flapper valve 148 formed ofa circular rubber disk screwed onto said cup 147 by means of a screw149.

Inside the first container in which the trichloro ethylene is: tobe'hou'sed, an evaporating: aid 150i ishousedi (Figure: 16.)whichievapora'ting aid consists of.- a partiallyopen tubular member 151;mounted on said downwardly pro jecting. tube 140 and integral with twoparallel spaced apart rings 152 and 153 each having-a transverse bar 152and 153, respectively. Between said parallel spaced rings 152 and 153and said? transversebars 152' and 153 a pluralityofi absorbing: threads154 (Figure 11) are wound which thereby enlarge the evaporating surfaceof the first anaesthetic. housed in said first container 104. Theevaporating aid. 150 and more particularly the tubular member 151; ismerely fit onto the downwardly projecting tube 140 so thatuponunscrewing the container 104 from the threaded section 129" andwithout-emptying saidcontainer,.it is possibleto withdrawsaidevaporating aid 150 and to cleaner. replace the thread154. Also thefirst container 104,,rnay thus beseparately stored, containing theanaesthetic.

In the positionshown in. Figure 11, the oxygen which is supplied throughthe supply pipe 128enters the tubular member 131 passing through thecylindrical air connecting member 132 which is closed and enters theflow directing cylinder 136' where it changes its path due to partition137 passingthrough the circular bore 138, the downwardly projecting tube140 into the first container 104, wherein said oxygen is impregnatedwith trichloro ethylene vapors and rising in said container 104 throughsaid downwardly projecting tube 141, circular bore 139 again intotheflow directing cylinder but in the other sec tion with regard to thedisk-shaped partition 137 and then flowing towards the exit 147, openingthe one way valve 148.

If it is desired to cut out the trichloro ethylene vapors, it is onlynecessary torotate the flow directing cylinder 136 by rotating actuatingknob 145, so that the circular bores 138 and 139 coincide with theopenings 142 and 143, whereupon the access to the downwardly projectingtubes 140 and 141 is closed and the oxygen provided by supplypipe 128passes through the by-pass 144 from one section of the flow directingcylinder 136 to the other section, with regard to the disk-shapedpartition 137, flowing towards the exit 147.

On the cup 147 a bulb control member 155 is mounted, and this comprisesa cylindrical discharge member 156 having an actuating knob 157 emergingthrough a slot 158 (Figure 8) arranged in said bulb control member 155.Said cylindrical discharge member 156 is provided with a first opening159 and a second opening 160 which latter is only visible in Figure 8.In normal operative position said second opening 160 faces a closedportion of said bulb controlmember 155. Under determined circumstances,as will be later explained, said second opening 160 may at leastpartially face said slot 158 while the first opening159 is still incommunication with the downwardly projecting branch 161 so that a con.-nection is. established between the bulb or collapsible container 107and the exterior;

The downwardly projecting branch 161 is providedwith a bulb. supportingmember 162 having an upper ring 162 and a lower ring 1627 betweenwhichthe collar 107 is mounted, which thereby supports said bulb 107. This isusually a thin rubber bulb for accumulating the trichloro ethylenevaporscoming from the exit 147" and may be discharged towards the mask208, by compressing with the hand, said bulb 107, as well be laterexplained.

Under certain circumstances it may be advisable to.

mix the trichloro ethylene vapors with a second anaesthetic, such as forinstance ether, in order to reinforce the anaesthetic properties. Tothis end the second container 108 is mounted on a suitable support 163(see Figures 8 and and comprising a charge opening 164 closed by aclosure member 165, preferably provided with a chain 166 having a ball167 or the like at its free end which is larger than the internaldiameter of said charge opening 164 so that the closure member 165cannot be lost. The second: container 108. consists of a base member 168and atop member 169, between which a glass cylinder 170 is located sothat the volume of the second anaesthetic may easily be controlled. Saidtop member 169 supports the charge member 164 and further comprises the.stutfing box 171 for a dosimetric valve consisting of a handle 172integral with a threaded stem 173 having a needle 174. The stem isscrewed into a partially internally threaded bushing 175 having at itsportion adjacent to said base member 168 an opening 176, through whichthe ether enters and passes downwardly by said needle 174. A glass sight177 enables the flow of ether to be controlled which is usuallyadropwise flow by controlling the handle 172. The lower end portion ofthe sight 177 is connected to a tube 178 (see Figure 10) which entersinto the upper portion of the downwardly projecting branch 161 (Figure11).

The free end of tube 178 faces a wire net filter 179 clamped betweenupper and lower circular wires 180 mounted into corresponding groovesarranged in said downwardly projecting branch 161. This filter 179 alsoassures that a good evaporation of the reinforcing anaesthetic takesplaceand in order to avoid that the latter may drop in liquid form intothe rubber bulb 107, a cup shaped trap 181 is provided and supported bya U-shaped wire support 182 (Figure 9) which is fixed to the lower edgeof the downwardly directed branch 161.

It is thus understood that the rubber bulb 107 constitutcs a storingcontainer for the anaesthetic or anaesthetics and the continuouslyproduced vapors of anaesthetics which are gradually stored are suppliedwith every inspiration by the patient, while during the expirationsufficient time passes to accumulate a new charge.

. Under certain circumstances it is however desirable to supply insteadofv a charge of anaesthetics, a charge of pure oxygen. to which end itis necessary in first instance to quickly establish by actuating knob157 a connection between the interior of the bulb 107 and the exterior.Thus, by compressing the bulb 107 the content thereof is dischargedthrough the second opening 160 (see Figure 8) and thereafter the bulb107 is released, the air connection 160 is again closed by knob 157 andthe bulb 107 may be charged with oxygen, as will be now explained.

To this end a direct connection between the flow control valve means 102and the bulb 107 is provided, consisting of a tube 183 (see Figure 9)connected to the second branch 120 of the casing 110 at one end and to apush button valve 184 (Figure 8) at the other end. This push buttonvalve184 (see Figures 14 and 15) consists of a casing 185 screwed onto themain su port 101 by means of a nut 186. The casing is provided with anintake pipe 187 connected to said tube 183 and a discharge pi e 188. Avalve head 189 having a sealing member 190 capable of entering insealing contact with a seat 192 integral with said casing 185 isoperated by a push button 191 and a helical compression spring 193located between said valve head 189 anda cup-screw 194 normallymaintains said valve head 189 in closed position so that no connectionis established between the intake pipe 187 located at one side of saidseat 192 and said discharge pipe 188. The discharge pipe 188 isconnected by means of tube 231 (see Figures 8, 9 and 10) to a downwardlydirected branch 161,

Thus, as previously explained, once the rubber bulb 107 isdischarged,vthe push button 191 is pressed downwardly, whereby animmediate flow of oxygen enters said rubber bulb 107..

The main supportltll is provided in the middle portion of its back sidewith a recess 195 (see Figure 9) into which the upper part of a holder196 (see Figures 17 and 18) may be. fitted, which holder is of theclamping type for holding or supporting the apparatus of the presentinvention. To this end, said holder 196 comprises a forkli ke member 197integral with a vertical branch 198' of an L-shaped bar 198, thehorizontal branch 198" of which supports at its free end a screw 199operable by means of handle 200 and comprising a jaw 201 slideablyengaging at one end said vertical branch 198' and being screwed to thefree end of said screw 199 by means of a screw handle 200, the holder isfixed to the table and thereby the assembly is supported.

The bulb control member 155 comprises a coupling end 205 (see Figures 8,9, l and 11) to which a coupling end (not shown) of a corrugated rubbertube 206 (see Figure 19) may be connected, and this has a second metalcoupling end 207 similar to the first coupling end which is notshown,for coupling said corrugated rubber tube 206 to a mask 208. i

The mask is preferably formed of a rubber mouth and nose piece 209 ofthe known type and which has only been partially shown and which ismounted on a cylindrical member 210 (Figure 20) having a downwardlydirected branch 211 which is provided at its free end with aninspiration flapper valve 212. Said valve will open when the patient isinspirating, so as to normally withdraw the content of vapors housed inthe collapsible container or bulb 107. During the expiration, said valvecloses and thus the carbon anhydride cannot enter into the bulb 107 norcan it enter into the first container 104 which is also provided forsafety purposes with the flapper valve 148 (see Figure 11) as alreadypreviously explained.

The cylindrical member 210 comprises a slot 213 and a flow directingcylinder 214 (Figure 21) provided with an actuating knob 215 emergingout through said slot 213. Said flow directing cylinder 214 is rotatablymounted in said cylindrical member 210 and comprises a circular lateralopening 216, an oblong lateral opening 217 and a back opening 218 (seeFigure 20). Whenthe circular lateral opening 216 coincides with theopening of the downwardly directed branch 211, the oblong lateralopening 217 faces the internal wall of the cylindrical member 210, sothat the connection is established between the bulb 107 and the mask209. On the other hand if by actuating knob 215 the oblong lateralopening 217 coincides with the slot 213, the circular lateral opening216 faces the internal wall of the cylindrical mem-' her 210 as shown inFigure 20, whereby the connection to the downwardly connected branch 211from the mask' 209 is interrupted and the mask is connected to theexterior. The back opening 218 is controlled by an adjustable throttlevalve 219 consisting of a valve head 220 having a stem 221 slideablymounted in a displaceable bushing 222 screwed into the base portion 210of the cylindrical member 210. A plurality of peripheral holes 223 arearranged in the cylindrical member 210 adjacent to the back opening 218and behind said flow directing cylinder 214. The throttle valve 219 isthe expiration valve which normally allows the expiration which leavesthe cylindrical member 210 through said purality of peripheral holes223.

Undercertain circumstances it may be desired to avoid the expiration fora moment, whereupon the operator has simply to press the stern 221 atits free end so that the valve head 220 obturates the back opening 218If the larger contractions of the strong muscular wall'of the abdomen,such a procedure may be required. If it is say to allow that the valvehead 200 opens only in a very apparatus is used in birth delivery, inorder to provokesmall extent, all that is necessary to do is to screw inthe bushing 222 so that its front end 222' (see Figure 20) is located ata small distance from the back opening 218, whereby the valve head 220cannot move backward the normal extent. Finally it is obviously possibleto completely lock said valve 219 by pressing the valve head 220continuously onto the base portion 214' of the flow directing cylinder214, which is carried out by advancing the bushing 222 so as to lock bymeans of its front end 222' said valve head 220.

If the apparatus of the present invention is used in childbirth, it maybe convenient to be able to initiate an artificial respiration on thechild immediately after it has been born to which end the secondarynipple 8 (see Figure 1) is provided, to which one end (not shown) of arubber tube 224, the other end of which is shown in Figure 22, isconnected, which rubber tube is connected to a branch 224 (Figure 23) ofa cylinder 226 provided at one end with a rubber mask 227 and having aconnection 228 onto which a collapsible container or bulb,

229 (only partially shown) for storing oxygen is fitted. The baseportion 226' has a central perforation 230 connecting the interior ofthe mask 227 to the outside.

If artificial respiration is required, all that is necessary is to openthe needle by-pass valve 9 (see Figure 1) whereby oxygen enters throughthe rubber 224 into the bulb 229 (see Figure 22) and by convenientlypressing and releasing said bulb 229 and opening and closing the centralperforation 230 with a finger or thumb, the

artificial respiration is carried out, as will be understood by anyoneskilled in the art.

The way of operating and controlling the apparatus for administratinganaesthetics has already been described during the above description andthe way of administrating the different gases, will depend on eachparticular case and on the type of operation or the like that it isbeing used in connection with, and it is not considered necessary toenter into these details for the purpose for which this apparatus hasherein been described.

I claim:

1. An apparatus for administration of anaesthetics, comprising an intakeconnection for oxygen and the like, a constant flow pressure meansconnected to said intake connection, a fiow control valve meansconnected to said intake connection, a first container for housing andevapoflow directing device being connected to said flow con-- trol valvemeans, said first container being connected to said flow directmgdevice, control means in said flow directing device for directlyconnecting said admission end to said exit and closing off said firstcontainer, a one way valve connected to said exit permitting flow fromsaid admission end through said exit, a collapsible container connectedto said one way valve, a second container for housing a secondanaesthetic, said second container, being connected to said collapsiblecontainer and an administrating mask connected to said collapsiblecontainer.

2. An apparatus for administration of anaesthetics, comprising an intakeconnection for oxygen and the like, aconstant flow pressure meansconnected to said intake connection, a flow control valve meansconnected to said intake connection, a first container for housing andevaporating a first anaesthetic, a flow directing device having anadmission end and an exit, said admission end of said flow directingdevice being connected to said. flow control valve means, said firstcontainer being connected to said flow directing device, control meansin said how directingdevice for directly connecting said admission endto said exit and closing ofi said first container, a one way valveconnected to said exit permitting fiow from said admission end throughsaid exit, a collapsible container connected to said one way valve, a

second container for housing a second anaesthetic and,

having a flow control, .said second container being connected to saidcollapsible container, and an administrating mask connected to saidcollapsible container.

3. An apparatus for administration of anaesthetics, comprising an intakeconnection for oxygen and the like, a constant flow pressure meansconnected to said intake connection, a flow control valve meansconnected to said intake connection, a first container forhousingandevaporating a first anaesthetic, a flow directing devicehaving an admission end and an exit, said admission end of said flowdirecting device being connected to said flow control valve means, saidfirst container being connected to said flow directing device, controlmeans in said flow directing device for directly connecting saidadmission end to said exit'and closing otf said first container, a oneway valve connected to said exit permitting 'fiow from said admissionend through said exit, a collapsible container connected to said onewayvalve, a second container for housing a second anaesthetic and havinga flow control, said second container being connected to saidcollapsible container, said collapsible container being also directlyand controllably connected to said fiow control valve means, and anadministrating mask connected to said collapsible container.

4. An apparatus for administration of anaesthetics, comprising an intakeconnection for oxygen and the like, a constant flow pressure meansconnected to said intake connection, a flow control valve meansconnected to said intake connection, a first container for housing andevaporating a first anaesthetic, a fiow directing device having anadmission end and an exit, said admission end or said flow directingdevice being connected to said flow control valve means, said firstcontainer being connected to said flow directing device, control meansin said flow directing device for directly connecting said admission endto said exit and closing ofi said first container, a one way valveconnected to said exit permitting flow from said admission end throughsaid exit, a collapsible container connected to said one way valve, saidsecond container being connected to said collapsible container, saidcollapsible container beingalso directly and controllably connected tosaid flow control valve means, and an administrating mask connected 'tosaid collapsible container.

5. An apparatus for administration of anaesthetics, comprising aconstant-flow pressure means, an oxygen intake connection connected tosaid constant flow pressure means, a tlow control valve meansconnectcd'to said intake connection, a first container for housing andevaporating a first anaesthetic, a flow directing device having aby-pass, an admission end and an exit, said admission end of said Howdirecting device being connected to said flow control valve means, saidfirst container being connected to said flow directing device, controlmeans for controlling said first container and said by-pass in said flowdirecting device 'for directly connecting said admission end throughsaid by-pass to said exit and closing off said first container, a oneway valve connected to said exit permitting flow from said admission endthrough said exit, a collapsible container connected to said one wayvalve, a second container for housing a second anaesthetic and having afiow control, said second container being connected to said collapsiblecontainer,

said collapsible container being also directly and con trollablyconnected to said fiow control valve means, and an administrating maskhaving an inspiration valve and a controllable expiration valveconnected to said collapsible container.

6. In an apparatus 'for administration of anaesthetics, a constant flowpressure means adapted to be connected to a high pressure gaseoussupply.source, said constant flow pressure means comprising a main'casing, an,admission arm integral with said main casing and having coupling meansfor connecting said admission arm to said supply source and-a supplyboring in said admission arm,a constant flowjpressure valve and acontrol means for controlling said constant flow pressure valve, a mainnipple for forwarding gas under constant pressure, a needle by-passvalve, a secondary nipple controlled by said needle by-pass valve, saidmain casing comprising a front chamber, a back chamber and a mainpartition wall separating said front chamber from said back chamber,aprolongation connecting said supply boring to said back chamber, avertical boring connecting said manometer to said supply boring, atleast one cross bor' ing in said main partition wall connecting saidback chamber to said front chamber, a conduit connecting said frontchamber to said main nipple, said needle bypass valve being alsoconnected to said front chamber.

7. For an apparatus for administration of anaesthetics, a mask foradministrating said anaesthetics comprising a mouth and nose piece, acylindrical member connected to said mouth and nose piece, a branchconnected to i said cylindrical member having a base portion, aninspiration flapper valve in said branch, a flow directing cylinderrotatably housed in'said cylindrical member and having means forcontrolling said flow directing cylinder, there being a circular lateralopening, an oblong opening and a back opening in said'flow directingcylinder, there being a slot in said cylindrical member, said circularopening being capable of coinciding with said branch, said oblongopening being capable of coinciding with said slot when said circularopening is not coinciding with said branch, and an adjustable throttlevalve for controlling said back opening.

8. For an apparatus for administration of anaesthetics, a mask foradministrating said anaesthetics comprising an elastic mouth and nosepiece, a cylindrical mcmber connected to said mouth and nose piece, abranch connected to said cylindrical member having a base portion, aninspiration flapper valve in said branch, at flow directing cylinderrotatably housed in said cylindrical member and having means forcontrolling said flow directing cylinder, there being a circular lateralopening, an oblong opening and a back opening in said fiow directingcylinder, there being a slot in said cylindrical member, said circularopening being capable of coinciding with said branch, said oblongopening being capable of coinciding with said slot when said circularopening is not coinciding with said branch, an adjustable throttle valvefor controlling said back opening, said adjustable throttle valvecomprising a bushing displaceably mounted in said base portion of saidcylindrical member, a stem in said bushing and emerging out therefrom, avalve head integral with said stem capable of obturating said backopening, and there being a plurality of peripherical holes in saidcylindrical member adjacent to said back opening and in front of saidbushing.

9. {an apparatus for administration of anaesthetics, comprising aconstant flow pressure means, an intake connection connected to saidconstant flow pressure means, a flow control valve means connected tosaid intake connection, 'a flow measure means connected to said flowcontrol valve means, a first container for housing and evaporating afirst anaesthetic, an evaporating aid in said first container, 2. flowdirecting device "comprising a tubular member having an admission endportion and an exit end portion, there being a first slot in saidadmission end portion, a cylindrical air connecting membet-rotatablyhoused in said admission end portion and having a first actuating knobemerging through said first slot and accessible from outside,ja flowdirecting cylinder rotatably housed in said tubular member adjacent saidair connecting member, there being a second slot in said tubular member,a second actuating knob integral with said now directing cylinder andemerging. through said second slot and"'accessible from outside, therebeing a first circular bore and a second circular bore in said flowdirecting cylinder, at disk-shaped partition in said flow directingcylinder and separating said first and second circular bores, a firstdownwardly projecting tube and a second downwardly projecting tubeconnected to said tubular member, said first and second circular boresbeing respectively capable of coinciding with said first and seconddownwardly projecting tubes, a first opening and a second opening insaid tubular member, a by-pass connecting said first and secondopenings, said first and second circular bores being capable ofestablishing a connection with said first and second openings, saidfirst and second downwardly projecting tubes entering said firstcontainer supported by said flow directing device, a cup mounted on saidexit end portion having an exit, a one-way valve controlling said exit,a bulb control member mounted on said cup, a cylindrical dischargemember rotatably mounted in said bulb control member, means forcontrolling the position of said cylindrical discharge member, acollapsible bulb connected to said bulb control member, said cylindricaldischarge member being capable of connecting said bulb to said exit andto the atmosphere, a second container for housing a second anaestheticand having a flow control, said second container being connected to saidbulb control member, said bulb control member being also directly andcontrollably connected to said flow control valve means, and anadministrating mask connected to said collapsible container.

10. An apparatus for administration of anaesthetics comprising aconstant flow pressure means, an intake connection connected to saidconstant flow pressure means, a flow control valve means connected tosaid intake connection, a flow measure means connected to said flowcontrol valve means, a first container for housing and evaporating afirst anaesthetic, an evaporating aid in said first container, a flowdirecting device comprising a tubular member having an admission endportion and an exit end portion, there being a first slot in saidadmission end portion, a cylindrical air connecting member rotatablyhoused in said admission end portion and having a first actuating knobemerging through said first slot and accessible from outside, a flowdirecting cylinder rotatably housed in said tubular member adjacent saidair connecting member, there being a second slot in said tubular member,a second actuating knob integral with said flow directing cylinder andemerging through said second slot and accessible from outside, therebeing a first circular bore and a second circular bore in said flowdirecting cylinder, a disk-shaped partition in said flow directingcylinder and separating said first and second circular bores, 21 firstdownwardly projecting tube and a second downwardly projecting tubeconnected to said tubular member, said first and second circular boresbeing respectively capable of coinciding with said first and seconddownwardly projecting tubes, there being a first opening and a secondopening in said tubular member, a by-pass connecting said first andsecond openings, said first and second circular bores being capable ofestablishing a connection with said first and second openings, saidfirst and second downwardly projecting tubes entering said firstcontainer supported by said flow directing device, a cup mounted on saidexit end portion having an exit, a one-way valve controlling said exit,a bulb control member mounted on said cup, a cylindrical dischargemember rotatably mounted in said bulb control member, means forcontrolling the position of said cylindrical discharge member, a secondcontainer for housing a second anaesthetic and having a flow controltube connected to said flow control and having a downwardly projectingbranch integral with said bulb control member, a bulb supporting membermounted on said downwardly projecting branch, a collapsible bulbsupported by said bulb supporting member, a filter for said secondanaesthetic and mounted in said downwardly projecting branch, a cupshaped container located below said filter and supported by saiddownwardly projecting branch,

said tube entering said downwardly projecting branch above said filter,a push button valve connected to said flow control valve means and tosaid downwardly projecting member, and an administrating mask connectedto said bulb control member.

11. An apparatus for administration of anaesthetics comprising aconstant flow pressure means adapted to be connected to a high pressuregaseous supply source, said constant flow pressure means comprising amain casing, an admission arm integral with said main casing and havingcoupling means for connecting said admission arm to said supply sourceand a supply boring in said admission arm, a manometer, a constant flowpressure valve and a control valve for controlling said constant flowpressure valve, -a main nipple for forwarding gas under constantpressure, a needle by-pass valve, a secondary nipple controlled by saidneedle by-pass valve and a safety valve, said main casing comprising afront chamber, a back chamber and a main partition wall separating saidfront chamber from said back chamber, a prolongation connecting saidsupply boring to said back chamber, a vertical boring connecting saidmanom eter to said supply boring, at least two cross borings in saidmain partition wall connecting said back chamber to said front chamber,a conduit connecting said front chamber to said main nipple, said needleby-pass valve and said safety'valve being also connected to said frontchamber, an intake connection connected to said constant flow pressuremeans, a flow control valve means connected to said intake connection, aflow measure means connected to said flow control valve means, ,a firstcontainer for housing and evaporating a first anaesthetic, anevaporating head in said first container, a fiow directing devicecomprising a tubular member having an admission end portion and an exitend portion, there being a first slot in said admission end portion, acylindrical air connecting member rotatably housed in said admission endportion and having a first actuating knob emerging through said firstslot and accessible from outside, a flow directing cylinder rotatablyhoused in said tubular member adjacent said air connecting'member, therebeing a second slot in said tubular member, a second actuating knobintegral with said flow directing cylinder and emerging through saidsecond slot and accessible from outside,

there being a first circular bore and a second circular bore in saidflow directing cylinder, a disk-shaped partition in said flow directingcylinder and separating said first and second circular bores, a firstdownwardly projecting tube and a second downwardly projecting tubeconnected to said tubular member, said first and second circular boresbeing respectively capable of coinciding with said first and seconddownwardly projecting tubes, a first opening and a second opening insaid tubular member, a by-pass connecting said first and secondopenings, said first and second circular bores being capable ofestablishing a connection with said first and second openings, saidfirst and second downwardly projecting tubes entering into said firstcontainer, a cup mounted on said exit end portion having an exit, aone-way valve controlling said exit, a bulb control member mounted onsaid cup, a cylindrical discharge member rotatably mounted in said bulbcontrol member, means for con trolling the position of said cylindricaldischarge member, a second container for housing a second anaestheticand having a fiow control tube connected to said flow control and havinga downwardly projecting branch integral with said bulb control member, abulb supporting member mounted on said downwardly projecting branch, acollapsible bulb supported by said bulb supporting member, a filter forsaid second anaesthetic and mounted in said downwardly projectingbranch, a cup shaped container located below said filter and supportedby said downwardly projecting branch, said tube entering said downwardlyprojecting branch above said filter, a push button valve connected tosaid flow control valve means and to said downwardly proje'ctingmember,and an administrating mask connected to said bulb control member andcomprising an elastic mouth and nose piece, a cylindrical memberconnected to said mouth and nose piece, a branch connected to saidcylindrical member having a base portion, an inspiration flapper valvein said branch, 21 flow directing cylinder rotatably housed in saidcylindrical member and having means for controlling said flow directingcylinder, there being a circular lateral opening, an oblong opening anda back opening in said flow directing cylinder, there .being a slot insaid cylindrical member, said circular opening being capable ofcoinciding with said branch, said oblong opening being capable ofcoinciding with said slot when said circular opening is not coincidingwith said branch, an adjustable throttle valve for controlling said backopening, said adjustable throttle valve comprising a bushingdisplaceably mounted in said base portion of said cylindrical member, astem in said bushing and'emerging out therefrom, a valve head integralwith said stem capable of obturating said back opening, there being aplurality of peripheral holes in said cylindrical member adjacent tosaid back opening and in front of said bushing, an oxygenation maskconnected to said secondary nipple, and a holder for holding theapparatus.

12. An apparatus for administration of anaesthetics, comprising a highpressure gaseous supply source of oxygen and the like, a constant flowpressure means connected to said supply source, said constant flowpressure means comprising a main casing, an admission arm integral withsaid casing and having coupling means for connecting said admission armto said supply source and a supply boring in said admission arm, aconstant flow pressure valve and a control valve for controlling saidconstant flow pressure valve, a main nipple for forwarding gas underconstant pressure, a needle by-pass valve, a secondary nipple controlledby said needle bypass valve and a safety valve, said main casingcomprising a front chamher, a back chamber and a main partition wallseparating said front chamber from said back chamber, a prolongationconnecting said supply boring to said back chamber, at least one crossboring in said main partition wall connecting said back chamber to saidfront chamber, a conduit connecting said frontchamber to said mainnipple, said needle bypass valve and said safety valve being alsoconnected to said front chamber, an intake connection connected to saidmain nipple, flow control valve means connected to said intakeconnection, afirst container for housing and evaporating a firstanaesthetic, a flow directing device having a by-pass, an admission endand an exit,

said admission end of said flow directing device being connected to saidflow control valve means, said first container being connected to saidflow directing device, control means for controlling said firstcontainer and said by-pass in said How directing device for directlyconnecting said admission end through said by-pass to said exit andclosing off said first container, a one way valve connected to said exitpermitting flow from said admission end to said exit. a collapsiblecontainer connected to said one way valve, a second container 'forhousing a second anaesthetic and having a flow control, said secondcontainer being connected to said collapsible container, saidcollapsible container being also directly and controllably connected tosaid flow control valve means, an administering mask for administeringthe anaesthetic housed in said collapsible container, said maskcomprising a mouth and nose piece, a cylindrical member connected tosaid mouth and nose piece, a branch connected to said cylindrical memberhaving a base portion, an inspiration flapper valve in said branch, aflow directing cylinder rotatably housed in said cylindrical member andhaving means for controlling said fiow directing cylinder, there being acircular lateral opening, an oblong opening and a back opening in saidflow directing cylinder, ,there being a slot in said cylindrical member,said circular opening being capable of coinciding with said branch,saidcblong opening being capable of coinciding with said slot when saidcircular opening is not coinciding with said branch and an adjustablethrottle valve for controlling said back opening, a tube connected tosaidinspiration flapper valve and to said collapsible container, ,asecond mask, a cylinder connected to said second mask, a perforation insaid cylinder, a branch connected to said cylinder and to said secondnipple, a connection connected to said cylinder, and a bulb con nectedto said connection.

13. For an apparatus for administration of anaesthetics, a mask foradministrating said anaesthetics, a body member connected to said mask,a branch connected to said body member-and having a base portion, aninspiration valve in said branch, a flow directing cylinder rotatablyhoused in said body member and having means for controlling said flowdirecting cylinder, there being a circular opening, an oblong openingand a back opening in said flow directing cylinder, there being a slotin said body member, said circular opening being capable of coincidingwith said branch, said oblong opening being capable of coinciding withsaid slot when said circular opening is not coinciding with said branch,and an adjustable valve for controlling said back opening.

References Cited in the file of this patent UNITED STATES PATENTS Re.15,874 Heidbrink July 22, 1924 514,628 Smithard Feb. 13, 1894 1,433,104Foregger Oct. 24, 1922 1,500,614 Heidbrink July 8, 1924 1,500,615Heidbrink July 8, 1924 1,763,305 Heidbrink June 10, 1930 FOREIGN PATENTS803,000 France June 22, 1936

